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4-Point C2 Fixation for Occipitocervical Fusion: Technical Case Report.

John K Houten¹, Merritt D Kinon², Gila R Weinstein³

¹Department of Surgery, Maimonides Medical Center, Brooklyn, New York, USA; Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA.

World Neurosurgery

|January 10, 2021

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Occipitocervical fusion can be enhanced with a novel 4-point C2 fixation technique. This method may prevent the need for fusion extension into the subaxial spine, preserving motion segments.

Area of Science:

Neurosurgery
Orthopedic Surgery
Spinal Fusion Techniques

Background:

Occipitocervical (OC) fusion addresses upper cervical and craniocervical junction instability.
Current fixation methods at the occiput are robust, but cervical fixation presents challenges.
Extending fixation to the midcervical spine sacrifices motion segments and increases morbidity.

Observation:

The C2 vertebra offers unique anatomical advantages for screw fixation.
Translaminar and pars screw techniques are distinct yet complementary for C2 fixation.
A novel 4-point C2 fixation strategy is introduced for OC fusion.

Findings:

A 4-point C2 fixation technique combining translaminar and pars screws is technically feasible.
This technique aims to avoid fusion extension into the subaxial spine.

Keywords:

Atlantoaxial subluxation Axis Cervical fusion OC fusion Occipitocervical fusion Translaminar screw

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The described method utilizes the unique morphology of the C2 vertebra.

Implications:

This 4-point C2 fixation may spare subaxial motion segments during OC fusion.
Further research could explore its application in other surgical procedures.
This technique offers a potential solution to minimize surgical morbidity in OC fusion.